학술논문
Factors Associated with Time to Conversion from Active Surveillance to Treatment for Prostate Cancer in a Multi-Institutional Cohort.
Document Type
Academic Journal
Author
Cooley LF; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.; Emeka AA; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.; Meyers TJ; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.; Cooper PR; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.; Lin DW; Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Public Health Sciences, Seattle, Washington.; Department of Urology, University of Washington, Seattle, Washington.; Finelli A; Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.; Eastham JA; Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.; Logothetis CJ; Departments of Genitourinary Medical Oncology and Urology, the University of Texas M. D. Anderson Cancer Center, Houston, Texas.; Marks LS; Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California.; Vesprini D; Odette Cancer Centre, Sunnybrook Health and Sciences Centre, University of Toronto, Toronto, Ontario, Canada.; Goldenberg SL; Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.; Higano CS; Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.; Pavlovich CP; The Brady Urological Institute, the Johns Hopkins University School of Medicine, Baltimore, Maryland.; Chan JM; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.; Department of Urology, University of California, San Francisco, San Francisco, California.; Morgan TM; Department of Urology, University of Michigan, Ann Arbor, Michigan.; Klein EA; Glickman Urological and Kidney Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio.; Barocas DA; Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.; Loeb S; Departments of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs Medical Center, New York, New York.; Helfand BT; Division of Urology, NorthShore University Health System, Evanston, Illinois.; Scholtens DM; Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.; Witte JS; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.; Department of Urology, University of California, San Francisco, San Francisco, California.; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California.; Catalona WJ; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Source
Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 0376374 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3792 (Electronic) Linking ISSN: 00225347 NLM ISO Abbreviation: J Urol Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: We examined the demographic and clinicopathological parameters associated with the time to convert from active surveillance to treatment among men with prostate cancer.
Materials and Methods: A multi-institutional cohort of 7,279 patients managed with active surveillance had data and biospecimens collected for germline genetic analyses.
Results: Of 6,775 men included in the analysis, 2,260 (33.4%) converted to treatment at a median followup of 6.7 years. Earlier conversion was associated with higher Gleason grade groups (GG2 vs GG1 adjusted hazard ratio [aHR] 1.57, 95% CI 1.36-1.82; ≥GG3 vs GG1 aHR 1.77, 95% CI 1.29-2.43), serum prostate specific antigen concentrations (aHR per 5 ng/ml increment 1.18, 95% CI 1.11-1.25), tumor stages (cT2 vs cT1 aHR 1.58, 95% CI 1.41-1.77; ≥cT3 vs cT1 aHR 4.36, 95% CI 3.19-5.96) and number of cancerous biopsy cores (3 vs 1-2 cores aHR 1.59, 95% CI 1.37-1.84; ≥4 vs 1-2 cores aHR 3.29, 95% CI 2.94-3.69), and younger age (age continuous per 5-year increase aHR 0.96, 95% CI 0.93-0.99). Patients with high-volume GG1 tumors had a shorter interval to conversion than those with low-volume GG1 tumors and behaved like the higher-risk patients. We found no significant association between the time to conversion and self-reported race or genetic ancestry.
Conclusions: A shorter time to conversion from active surveillance to treatment was associated with higher-risk clinicopathological tumor features. Furthermore, patients with high-volume GG1 tumors behaved similarly to those with intermediate and high-risk tumors. An exploratory analysis of self-reported race and genetic ancestry revealed no association with the time to conversion.
Materials and Methods: A multi-institutional cohort of 7,279 patients managed with active surveillance had data and biospecimens collected for germline genetic analyses.
Results: Of 6,775 men included in the analysis, 2,260 (33.4%) converted to treatment at a median followup of 6.7 years. Earlier conversion was associated with higher Gleason grade groups (GG2 vs GG1 adjusted hazard ratio [aHR] 1.57, 95% CI 1.36-1.82; ≥GG3 vs GG1 aHR 1.77, 95% CI 1.29-2.43), serum prostate specific antigen concentrations (aHR per 5 ng/ml increment 1.18, 95% CI 1.11-1.25), tumor stages (cT2 vs cT1 aHR 1.58, 95% CI 1.41-1.77; ≥cT3 vs cT1 aHR 4.36, 95% CI 3.19-5.96) and number of cancerous biopsy cores (3 vs 1-2 cores aHR 1.59, 95% CI 1.37-1.84; ≥4 vs 1-2 cores aHR 3.29, 95% CI 2.94-3.69), and younger age (age continuous per 5-year increase aHR 0.96, 95% CI 0.93-0.99). Patients with high-volume GG1 tumors had a shorter interval to conversion than those with low-volume GG1 tumors and behaved like the higher-risk patients. We found no significant association between the time to conversion and self-reported race or genetic ancestry.
Conclusions: A shorter time to conversion from active surveillance to treatment was associated with higher-risk clinicopathological tumor features. Furthermore, patients with high-volume GG1 tumors behaved similarly to those with intermediate and high-risk tumors. An exploratory analysis of self-reported race and genetic ancestry revealed no association with the time to conversion.